Primary Care, Allied Health & Medical Professional Referral Form

Any health professional can make a referral to Proactive pain service for privately or private insurer funded services. Under the ACC funded Pain Service, it must be a registered primary care or secondary care health professional and the client must have an accepted ACC Claim and score >50 on the obrebro short form screening questionnaire.

For making a referral to our non ACC pain service click here.

For making a referral to our ACC funded pain service follow these steps:

  1. Complete the short form obrebro questionnaire.
  2. If after appropriate scoring, the client scores >50 they are eligible for the service.
  3. Send the completed orbro and the ACC6273 referral form to us at referrals@proactive4health.co.nz.
  4. Our referrals and pain management team will be in touch with you to receipt the referral.
  5. We will liaise with ACC for the next steps for your client and keep you informed throughout.

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